Modern blood pressure medications are divided into 10 different groups according to their mechanism of action. The doctor, having studied the patient’s complaints and test results, prescribes one or more medications, which in no case should be changed independently. Heart and vascular medications are not ones that you can "recommend to a friend. "A wrong choice can lead to dire consequences. Antihypertensive drugs are all available by prescription. In this article we will consider their modern classification based on the active substances and the nature of the effect on the body.
People often ask pharmacies for new generation blood pressure medications without side effects. But this does not happen in practice. All effective medications have their side effects. You will have to spend a lot of time choosing your group of drugs for hypertension with your doctor. Test it, adjust the dose, or replace it altogether if the medication is not suitable.
Classification of drugs for high blood pressure (BP)
Diuretics or diuretics
Drugs that enhance kidney function remove salts and excess water. This leads to a decrease in circulating blood volume and a decrease in vascular resistance - pressure drops. Not all diuretics are suitable for this purpose. The main requirement for such drugs is the mildness and duration of the diuretic effect, and the ability to conserve potassium. Many drugs from this group are included in combination medications for hypertension.
The most common are thiazides. The drug based on the substance indapamide is available in pure form and in complex form. Hydrochlorothiazide and chlorthalidone are commonly found in blood pressure medications. Examples: substances chlorthalidone + atenolol, chlorthalidone + azilsartan. Numerous options include a complex of hydrochlorothiazide with different substances for hypertension: with quinapril, ramipril, candesartan, bisoprolol, losartan, valsartan. Indapamide is more common with lisinopril, amlodipine and perindopril.
When diuretics are prescribed correctly by a doctor, side effects are practically non-existent. Potassium losses are not significant. Sometimes a patient has to change medications due to an allergic reaction. In some cases, your doctor may prescribe potassium supplements.
It happens that one type of diuretic is not enough. There is a drug that includes two diuretics: hydrochlorothiazide and triamterene (potassium sparing). The indications for this remedy are as follows: edema syndrome, liver cirrhosis and hypertension.
Drugs affecting the activity of angiotensin-converting enzyme (ACE)
Several systems function simultaneously in our body to maintain normal blood pressure. One of them is the renin-angiotensin system. We will not describe the features of its work, but we will only say that the main active substance that increases blood pressure is the oligopeptide angiotensin II. When a person experiences a disruption in vascular balance, angiotensin should be inhibited. A large group of drugs has been developed for this purpose.
Generations of blood pressure drugs affecting angiotensin II are continuously updated. Many well-known and popular remedies are already becoming outdated and are being replaced by more modern and effective ones.
It begins to act in approximately 1 hour and is active throughout the day. It is considered a strong drug. For this reason, many find it difficult to adjust the dosage; it is impossible to do this without a doctor. A particular side effect is an excessive decrease in blood pressure, which is dangerous. Sometimes the cardiologist is forced to completely discontinue a medicine from this group. But for severe headache symptoms, perindopril is an ideal choice, especially in combination with indapamide. Cough and shortness of breath when taking perindopril are much less common and less pronounced than when taking enalapril.
ACE blockers
The newest drugs for blood pressure without side effects such as cough are ACE blockers, they act in a similar way, but they have a higher safety profile. These are candesartan, eprosartan, irbesartan, losartan, telmisartan. Valsartans are no longer considered new.
Sartans reduce blood pressure after 3 hours, but the maximum effect occurs after 4-8 weeks of continuous use. Proper use of this drug reduces the risk of mortality in patients at high risk of cardiovascular pathologies. ACE blockers from the sartan group are more expensive than ACE inhibitors because they act more selectively and are better tolerated.
Beta and alpha adrenergic blockers
This group of drugs acts by reducing the activity of adrenaline, which increases blood pressure, frequency and strength of heart contractions. Adrenergic blockers are prescribed to people who do not respond to ACE inhibitors, as well as to patients with heart disease. Several generations of drugs are distinguished here. The earliest of them were drugs based on the substances atenolol and metoprolol. Now doctors prescribe medications with the active ingredient bisoprolol fumarate, alone or in combination with a diuretic component.
This drug acts primarily through the heart, reducing minute blood volume. Additionally affects blood vessels and renin activity. As a result, blood pressure and heart rate decrease. Prescribed for chronic heart failure, to prevent attacks of angina and to combat hypertension. Side effects can be dangerous: low pulse, dizziness, cardiac conduction disturbances.
Carvedilol has a combined adrenergic blocking effect. It is an alpha and beta adrenergic blocker. Belongs to a new generation and is considered a strong drug. Reduces pressure through the heart and peripheral vessels, dilating them. Prescribed for the treatment of stable angina, chronic heart failure and hypertension.
Nebivolol is a third generation beta blocker. It has a better vasodilator effect and a higher safety profile.
Calcium channel blockers
Calcium normally maintains myocardial contractility and vascular tone. A group of drugs has been developed that limit its effect in order to lower blood pressure in hypertension.
Calcium channel blockers are considered strong and are sometimes prescribed as an emergency treatment for very high blood pressure.
Preparations based on the substance amlodipine besylateprescribed for hypertension and angina pectoris. Side effects often include hypotension, palpitations, swelling, and deterioration of heart function. Medicines containing the substance lercanidipine hydrochloride reduce blood pressure primarily through the vascular bed and therefore have no side effects on the heart or they are significantly less pronounced. Among the indications there is only hypertension.
Imidazoline receptor agonists
This group of new blood pressure drugs is called alpha 2 central adrenergic agonists.
As we mentioned above, the vital support of pressure in the vascular bed is under the control of many systems in our body. One of them is the vasomotor center in the brain. The representative of the group, the substance moxonidine, reduces the activity of this center and the pressure decreases, the process occurs gradually.
Drugs based on moxonidine qualitatively reduce blood pressure. But unlike others, this substance is contraindicated in acute and chronic heart failure, and these pathologies often accompany hypertension.
Undesirable effects include dry mouth, diarrhea, drowsiness, headache, insomnia, and nervousness.
As we can see, there are no new blood pressure medications without side effects. The choice of medication will be made by the doctor based on studying blood tests, ECG and tonometer readings. Before visiting a doctor, you need to keep a diary of blood pressure values, where the pressure will be recorded in the morning, afternoon and evening.
Adherence to a diet low in salt, animal fats and light carbohydrates, as well as regular sports activities, has a positive effect.
To improve the functioning of the cardiovascular system, we can recommend nutritional supplements with important elements. For example, selenium, magnesium, potassium. They are contained in many popular dietary supplements and vitamin complexes.
Dietary supplement with omega 3 supports vascular health and regulates blood pressure. There is a wide variety of drugs available in pharmacies.